Individual
MR. VIRGILIO GONZAGA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1401 PELHAM PKWY N, BRONX, NY 10469-5809
(917) 331-7177
Mailing address
174 BAIER AVE APT 106, SOMERSET, NJ 08873-2043
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
725963
NY
Other
Enumeration date
02/18/2018
Last updated
07/22/2021
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